In this condition large, tense blisters develop in which there are antibodies attached to the upper layer of the basement membrane at the dermo-epidermal junction, with an underlying inflammatory reaction producing a split above the basement membrane. Lysosomal enzymes are released damaging the basement membrane, resulting in separation of the epidermis and blister formation. The presence of

Type IV—delayed hypersensitivity

Reaction to metal

Blistering disorder as a result of an Split at dermo-epidermal junction autoimmune response

Reaction to metal

Direct immunofluorescence antibodies, usually IgG, can be shown by an antihuman IgG antibody labelled with fluorescein. When viewed under the microscope with ultraviolet light illumination, the presence of the IgG antibody is shown by fluorescence. The presence of circulating antibasement membrane antibodies in the serum can be shown either by direct immunofluorescence using a specimen of the patient's skin or by incubation by attachment to skin which has been incubated in serum from the patient.

The clinical features are described in chapter 8. The blisters develop, frequently with an erythematous background, on the limbs, trunk, and flexures. It is mainly seen in the elderly and is slightly more common in women.

Fluorescein labelled antibody to human immunoglobulin

Antibody in patient's serum, placed on section

Antigen similar to human Substrate (usually animal tissue)

Indirect immunofluorescence Pemphigus

In this condition, antibodies are found to have developed against the epidermis above the basement membrane. The main antibody is IgG, but IgM and IgA may also be found. As a result of this reaction, there is separation of the epidermal cells with the formation of a superficial blister. A row of basal cells remains attached to the basement membrane. Direct immunofluorescence of the skin from affected patients shows that antibodies are deposited on the intercellular substance of the epidermis. Circulating antibodies are often present. Oral lesions are much more common than in pemphigoid.

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

Get My Free Ebook

Post a comment